I’m fairly new to this forum, but not to Type 1 diabetes. I’ve been diabetic for 38 years, on a pump for 24 and Dexcom for 5 years. Diabetes has always been hard to control. I’m pretty active, playing competitive tennis 1-4 times a week, depending on season. I play for an average of 2 hours each time. I’m 5’2’’ and did weigh 110, but now at 106, trying to gain weight by eating more and now drinking protein supplement 2 times a day. Last A1C7.6, down from 7.9.
Yes, I totally agree that if I eat fewer carbs that blood sugars are better, but how on earth can I keep the calories I need with fewer carbs? What do I eat?
I think another reason may be that I don’t take much insulin–22/26 units per day, so not much room for error due to sensitivity to insulin.
I read some about that flatlining, but that scares me as now I’ve had diabetes long enough that I sometimes do not feel a low coming on til I’m really in the hole–40-50.
Any advice from other long term diabetics is especially appreciated. BTW, I don’t find that my doctor is overly interested in this, BUT I had A1C’s in the high 6’s and never over 7 until I had a hysterectomy. That was over 20 years ago. There is definitely a line in the sand there, and I’ve never gotten the control that I used to have, even though I am trying much harder.
Thanks for your input.
Quite a few low-carb foods are rich in calories…
Are you using a pump and/or CGM? Because an A1c as high as yours, at least in the way that I approach managing my daughter’s Type 1, is a clear indication that you are not taking enough insulin to cover your daily carb intake plus your basal needs. Eating fewer carbs does not automatically mean that one’s blood sugars will be significantly “better” if you are not adequately covering your basal needs. With scary lows accompanied by a high A1c (I consider anything over 6.5 to be a too-high A1c) I suspect that you might be bolusing too much insulin per carb to compensate for inadequate basal rates. Have you ever done basal testing? That might be a good place to start.
Your onset of A1c’s in the 7’s may very well have nothing to do with your hysterectomy; remember that correlation does not equal causation. Not understanding this very important concept is what lead to widespread belief in the dangerous falsehood that immunizations were the cause of or “triggered” the development of autism.
. . . and, just for the sake of completeness, its companion aphorism: The plural of “anecdote” is not “evidence”.
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The calories in a low carb diet come mostly from healthy fats and protein. A low carb diet is necessarily a higher fat diet.
Yes, to basal testing. With basals set right and a low carb diet, bolus insulin requirements may be fairly low.
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I would really recommend keeping a journal of what you eat. Many people that restrict carbs fail because they don’t adequately increase other macronutrients, particularly fat. We have had it beat into our heads that fats are bad and if you can’t get your head around higher fat intake you can end up eating way too few calories on a low carb diet.
If you keep a journal you can get a much better idea about what you are eating. I would not be surprised if you are not eating enough fat and you are not getting enough calories.
Specifically, if you are wanting some low-carbohydrate foods that are high in calories, and are widely considered healthy (not just in the LCHF community), you should try increase things like Avocado, Olives, Nuts, Eggs but also Meats high in fats and things like cheese.
You can also try drizzling oils onto your foods (olive oil, sesame oil to name a few). But as Brian says above, keep your own food diary, if you have an iPhone or android something like MyFitness Pal is great, overtime you can move away from it once you start to learn what works for you.
I think it’s an interesting point you raise about not feeling lows until you are in the 40 or the 50s. Personally that wouldn’t bother me too much, the problem is if you don’t feel your lows once you drop below 50. I could be wrong but I believe hypoglycaemic unawareness is classified as not being able to identify hypoglycaemia from 3 mmol/ml or under (roughly 54 mg/dl). Now, with an insulin taking individual I think it is wise to be cautious of having levels under the higher 3s or under 70 mg/dl, some may disagree with that, but it’s harder to judge if you are running levels that low, if it will just drop and you won’t notice.
An important thing to note, in my opinion at least, if you are coming from a higher carb diet to a lower carb diet, you will probably lose some of what you thought to by hypoglycaemic recognition as your blood sugar averages reduce in general (for instance I personally used to feel my Blood glucose being ‘low’ when it was in the lower end of the 4s. After a year of improved control that is no longer the case). Another important point is that if you are eating less carbohydrates, you are giving less insulin, so a low in the 40 or the 50s, whilst still dangerous and needs attention, isn’t really comparable to the same low when you are eating 200-300 grams of carbohydrates a day and maybe giving 12 units of insulin with a meal.
